Ten Common Medicinal Herbs

Bernd Wollschlaeger, M.D.

info@miamihealth.com

Herb

Indication

Precaution

Interaction

Dosing

Echinacea

Leaf, stalk, root

 URI treatment and prevention;

Immunestimulation;

Antimicrobial

 Immunesuppression with continuous use;

Contraindicated in autoimmune disease;

 None reported Not standardized;

Dried extract:300-400mg TID;

Tincture: 30-50drps.TID

Children <10yrs. 50% dose

Feverfew

Tanacetum parthenium

 Treatment of Migraine;

Headache prophylaxis;

Postulated spasmolytic effects;

Not effective in RA

 GI irritation (5-15%);

Rebound headache ;

May potentiate platelet inhibitors and Increase bleeding;

 Interaction with anticoagulants and platelet inhibitors Standardized parthenolide content no less than 0.2%;

25-75mg of dried leave extract BID, max 125mg daily.

Garlic

Allium sativum

Crushed cells of bulb release alliin converted to active allicin.

>9% decrease in Cholesterol, LDL, TG, Increase HDL ;

Mild antihypertensive;

Antiplatelet; Antioxidants;

Antimicrobial;

May prevent malignancies.

 No serious side effects known;

Halitosis, topical irritation, GI upset;

 May potentiate hypoglycemic &antiplatelet therapy. Not standardized;

Fresh cloves: 0.5 –1 g QD

Pills: 600-900mg QD (standardized to 0.6%-1.3% allicin)

Powder: 04-1.2gr.

Ginger

Zingiber officinale

 Antiemetic-Motion Sickness, chemotherapy, surgery, pregnancy;

Antiinflammatory-Arthritis;

Possible positive inotropic effects.

 No serious side effects known;

Minor effects: GI upset and allergy (rare) Inhibits thromboxane synthetase (platelet aggregation) and is a prostacyclin agonist (prolonged bleeding time).

 Interacts with antiplatelet and anticoagulant therapy. Not standardized.

Capsules: 250-1000mg.

Adult dose: 1gr 30 minutes prior to travel, then 0.5-1.0 gr. q4 hrs (max.daily 2-4gr.).

Prior to chemotherapy: 1gr. PO

Ginkgo

Ginkgo biloba Leaf extract

 Dementia: slows cognitive deterioration.

Claudication: improves pain-free walking distance.

Tinnitus, Vertigo, SSRI induced sexual dysfunction.

 Ginkgolipide is a selective antagonist of platelet aggregation;

Minor GI upset;

Reported HA.

 Interacts with antiplatelet and anticoagulant therapy. Standardized extract contains 6% terpenoids and 24% flavenoids.

Adult dose: 60-80mg leaf extract BID-TID.

Effects can take from 1-2 months to appear.

Treatment duration: 6-12 weeks.

Herb

Indication

Precaution

Interaction

Dosing

Ginseng

Panax ginseng

Root extract

 Endurance and adaptation enhancer;

Increase in cognitive function; Resistance to stress; Immune and endocrine stimulant.

 Nervousness and agitation; Headache, Insomnia and palpitation;

Estrogenic effects can cause mastalgia and vaginal bleeding.

 Avoid use with other stimulants;

Possible interaction with Furosemide;

May increase digoxin level.

 Not standardized.

Adult dose: 1-2 gr. of root daily or 100-300mg of extract (standardized to contain 7% ginsenosides) TID for 3-4 weeks.

Milk Thistle

Silybum marianum

Fruit extract

(silymarin is a mixture of derivatives found only in the fruit)

 Hepatoprotective and antioxidant;

Indication: acute hepatitis from toxins(mushrooms, alcohol).

Chronic active hepatitis.

Cirrhosis – questionable

 No serious side effects known;

Mild diarrhea. One report of allergic urticaria.

DO NOT USE IN DECOMPENSATED CIRRHOSIS.

 None reported. Standardized extract contains 70% of silymarin.

Adult dose: Capsule 140mg BID-TID,

Acute poisoning: i.v. silymarin 20-50mg/kg per day.

Ma Huang

Ephedra sinica

Over 40 species, whose contents vary, some contain alkaloids.

 Asthma: Bronchodilator, vasoconstrictor, may reduce bronchial edema.

Weight Loss: not shown to be safe and effective, although it is a common ingredient of WT loss products.

 Can cause hypertension, CNS stimulation, hyperglycemia.

MISUSE HAS CAUSED DEATHS.

 Avoid use with CNS stimulants. No standardized products available.

North and Central American products (E. nevadensis-Mormon Tea) contain no alkaloids.

Adult dose: 2g ( 1 heaping tsp.-15-30mg of ephedrine) in 240ml of boiling water, steep for 10 minutes.

Saw Palmetto

Serenoa repens

Fruit of the

Sabal Palm

 Benign prostatic hyperplasia (BPH);

Increase urinary flow and decreases frequency.

Efficacy=Finasteride;

5 alpha-reductase inhibition.

 No serious side effects or drugs interactions known.

Not associated with decreased libido or changes in PSA.

Mild GI upset, HA, diarrhea.

 None reported. Standardized extract contains 85%-95% fatty acids and steroids.

Adult dose: 320mg PO QD

St. Johns Wort

Hypericum perforatum

Flower, Leaf

 Mild to Moderate Depression.

Anti-inflammatory activity.

 Large dosage can cause photosensitization.

Can increase serotonin levels.

No clinical MAOI-inhibition.

 Don’t take with SSRI’s or other antidepressants. Standardized extract contains 0.3% hypericin.

Adult dose: 300mg PO TID no more than 8 weeks.

Long term use not yet studied.

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